Individual provider Active NPI

Paul D Roesler, CRNA

  • Certified Registered Nurse Anesthetist
  • Ardmore, OK
National Provider Identifier
1346263118
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
44017 Issued in OK
Practice address
1011 14TH Ave NW
Ardmore, OK 73401-1828
Phone
(918) 558-1920
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X R0044017 OK
Certified Registered Nurse Anesthetist 367500000X 44017 OK Primary

Addresses

Primary practice location

1011 14TH Ave NW
Ardmore, OK 73401-1828

Mailing address

251 Rogers Cir
Durant, OK 74701-1728
Phone (580) 916-2666

Other practice location 1

1801 W 3rd St
Elk City, OK 73644-5145
Phone (580) 225-5403

Other practice location 2

6161 S Yale Ave
Tulsa, OK 74136-1902
Phone (918) 494-0612

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OK, WI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110802000642 OK Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052580339 Reassigns benefits to 4 organizations
I20220429001586 WI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1052580339 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
R0044017OKMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeview Medical Center Inc of Rice Lake CurrentSince May 31, 2022 Accepting new patients
Surgical Hospital of Oklahoma LLC CurrentSince Oct 3, 2023 Accepting new patients
Choctaw County City of Hugo Hospital Authority CurrentSince Mar 28, 2016 Accepting new patients
Anesthesia Management Solutions of Oklahoma PLLC Anesthesiology CurrentSince Apr 22, 2019 Accepting new patients
Western Oklahoma Anesthesia Consultants PLLC Anesthesiology CurrentSince Apr 16, 2018 Accepting new patients
MCHS Hospitals Inc Anesthesiology CurrentSince May 31, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince May 31, 2022 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince May 31, 2022 Accepting new patients
Marshfield Clinic Inc CurrentSince May 31, 2022 Accepting new patients
Beaver Dam Community Hospitals Inc CurrentSince May 31, 2022 Accepting new patients

Locations

430 N Monte Vista St
Ada, OK 74820
Phone (580) 226-1251

1800 W University Blvd
Durant, OK 74701
Phone (580) 924-3080

1901 W 3rd St
Ste C
Elk City, OK 73644
Phone (580) 225-9222

1801 W 3rd St
Elk City, OK 73644
Phone 5802255403677

1405 E Kirk St
Hugo, OK 74743
Phone (580) 317-9500

100 SE 59th St
Oklahoma City, OK 73129
Phone (405) 364-9789

3701 E Main St
Weatherford, OK 73096
Phone (580) 772-5551

900 17th St
Woodward, OK 73801
Phone (405) 610-4411

705 S University Ave
Beaver Dam, WI 53916
Phone (920) 885-6090

707 S University Ave
Beaver Dam, WI 53916
Phone (920) 887-4006

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

1000 N Oak Ave
#A
Marshfield, WI 54449

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

1700 W Stout St
Rice Lake, WI 54868
Phone (715) 236-6133

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714003200000",
    "number": "1346263118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "251 ROGERS CIR",
            "city": "DURANT",
            "state": "OK",
            "postal_code": "747011728",
            "telephone_number": "580-916-2666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 14TH AVE NW",
            "city": "ARDMORE",
            "state": "OK",
            "postal_code": "734011828",
            "telephone_number": "918-558-1920"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Elk City",
            "state": "OK",
            "postal_code": "736445145",
            "country_code": "US",
            "telephone_number": "580-225-5403",
            "fax_number": "580-225-5423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6161 S Yale Ave",
            "address_purpose": "LOCATION",
            "city": "Tulsa",
            "state": "OK",
            "postal_code": "741361902",
            "country_code": "US",
            "telephone_number": "918-494-0612",
            "fax_number": "918-481-5170",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROESLER",
        "first_name": "PAUL",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "OK",
            "license": "R0044017",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OK",
            "license": "44017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ardmore, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.